Venous Stasis Leg Ulcers: A Review
Keywords:
venous stasis leg ulcers, Up to date, review
Abstract
Chronic venous stasis ulcers (CVSU) of the lower extremity affect up to 5% of the population over 65 years and 1.5% of the general population. CVSU is caused by chronic venous disease produced by venous hypertension. Venous hypertension results from valvular incompetence within the deep venous system, or by the obstruction of venous outflow. Both of these mechanisms produce poor venous return. Additionally, poor mobility and decreased calf muscle pump function are thought to be contributing factors. Life-long use of compressive therapy is indicated in patients with chronic venous disease in lower extremities. It reduces ambulatory venous pressure. These include bandaging systems, garments (stockings), or devices.
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References
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2 Jha AK, Larizgoitia I, Audera-Lopez C, et al. The global burden of unsafe medical care: analytic modelling of observational studies. BMJ Quyal Saf 2013;22:809-15
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6 Crawford JM, Lal BK, Durán WN, Pappas PJ. Pathophysiology of venous ulceration. J Vasc Surg Venous Lymphat Disord 2017;5:596-605. 10.1016/j.jvsv.2017.03.015 28624002
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10 Hedayati N, Carson JG, Chi YW, Link D. Management of mixed arterial venous lower extremity ulceration: A review. Vasc Med. 2015;20(5):479–486.
11 Dix FP, Reilly B, David MC, et al. Effect of leg elevation on healing, venous velocity and ambulatory venous pressure in venous ulceration. Phlebology. 2005;20(2):87-94.
12 Finlayson K, Edwards H, Courtney M. Relationships between preventive activities, psychosocial factors and recurrence of venous leg ulcers: a prospective study. J Adv Nurs. 2011;67(10):2180-2190.
13 Gross EA, Wood CR, Lazarus GS, Margolis DJ. Venous leg ulcers: An analysis of underlying venous disease. Br J Dermatol. 1993;129(3):270–274
14 Orr L, Klement KA, McCrossin L, O’Sullivan D, Houghton PE, Spaulding S, Burke S. A systematic review and meta-analysis of exercise intervention for the treatment of calf muscle pump impairment in individuals with chronic venous insufficiency. Ostomy Wound Manag. 2017;63(8):30–43.
15 Jull A, Slark J, Parsons J. Prescribed exercise with compression vs com- pression alone in treating patients with venous leg ulcers: a systematic review and meta-analysis. JAMA Dermatol. 2018;154(11):1304-1311.
16 Andreissen A, Apelqvist J, Mosti G, Partsch H, Gonska C, Abel M. Compression therapy for venous leg ulcers: Risk factors for adverse events and complications, contraindications: A review of present guidelines. J Eur Acad Dermatol Venereol. 2017;31(9):1562–68.
17 Dolibog P, Franek A, Taradaj J, et al. A comparative clinical study on five types of compression therapy in patients with venous leg ulcers. Int J Med Sci. 2013;11(1):34-43.
18 Vivas A, Lev-Tov H, Kirsner RS. Venous leg ulcers. Ann Intern Med. 2016; 165(3):ITC17-ITC32.
19 Dolibog P, Franek A, Taradaj J, et al. A comparative clinical study on five types of compression therapy in patients with venous leg ulcers. Int J Med Sci. 2013;11(1):34-43.
20 Nelson EA, Bell-Syer SE. Compression for preventing recurrence of venous ulcers. Cochrane Database Syst Rev. 2014;(9):CD002303.
21 O’Meara S, Al-Kurdi D, Ologun Y, et al. Antibiotics and antiseptics for venous leg ulcers. Cochrane Database Syst Rev. 2014;(1):CD003557.
22 Tate S, Price A, Harding K. Dressings for venous leg ulcers. BMJ. 2018; 361:k1604.
23 Chapman S. Venous leg ulcer: An evidence review. Br J Community Nurs. 2017;22(Suppl 9):S6–S9.
24 James GA, Swogger E, Wolcott R, Pulcini ED, Secor P, Sestrich J, et al. Biofilms in chronic wounds. Wound Repair Regen. 2008;16(1):37–44.
25 Phillips PL, Yang Q, Davis S, Sampson EM, Azeke JI, Hamad A, et al. Antimicrobial dressing efficacy against mature Pseudomonas aeruginosa biofilm on porcine skin explants. Int Wound J. 2015;4(12)483–469.
26 Jull AB, Arroll B, Parag V, et al. Pentoxifylline for treating venous leg ulcers. Cochrane Database Syst Rev. 2012;(12):CD001733.
27 Scallon C, Bell-Syer SEM, Aziz Z. Flavonoids for treating venous leg ulcers. Cochrane Database Syst Rev. 2013;(5):1–41.
28 Martinez-Zapata MJ, Vernooij RW, Uriona Tuma SM, et al. Phlebot- onics for venous insufficiency. Cochrane Database Syst Rev. 2016;(4): CD003229.
29 Del Rio Sola ML, Antonio J, Fajardo G, Vaquero Pureta C. Influence of aspirin therapy in the ulcer associated with chronic venous insufficiency. Ann Vasc Surg. 2012;26(5):620–629.
30 Evangelista MT, Casintahan MF, Villafuerte LL. Simvastatin as a novel therapeutic agent for venous ulcers: a randomized, double-blind, placebo-controlled trial. Br J Dermatol. 2014;170(5):1151-1157.
31 Gethin G, Cowman S, Kolbach DN. Debridement for venous leg ulcers. Cochrane Database Syst Rev. 2015;(9):1–63.
32 Cardinal M, Eisenbud DE, Armstrong DG, et al. Serial surgical debride- ment: a retrospective study on clinical outcomes in chronic lower extremity wounds. Wound Repair Regen. 2009;17(3):306-311.
33 Falanga V. Wound bed preparation and the role of enzymes: a case for multiple actions of the therapeutic agents. Wounds. 2002;14(2): 47-57.
34 Dumville JC, Worthy G, Bland JM, et al. Larval therapy for leg ulcers (VenUS II): randomised controlled trial. BMJ. 2009;338:b773.
Barwell JR, Davies CE, Deacon J, Harvey K, Minor J, Sassano A, et al. Comparison of surgery and compression with compression alone in chronic venous ulceration (ESCHAR study): Randomised controlled trial. Lancet. 2004;363(9424):1854–59.
International Wound Infection Institute (IWII). Wound Infection in Clinical Practice: Principles of Best Practice. Wounds International. 2016. Retrieved from: www.woundinfection
O’Meara S, Al-Kurdi D, Ologun Y, Ovington LG, Martyn-St James M, Richardson R.
Antibiotics and antiseptics for venous leg ulcers. Cochrane Database Syst Rev. 2014;(1):1–190.
2 Jha AK, Larizgoitia I, Audera-Lopez C, et al. The global burden of unsafe medical care: analytic modelling of observational studies. BMJ Quyal Saf 2013;22:809-15
3 Guest JF, Fuller GW, Vowden P. Venous leg ulcer management in clinical practice in the UK: costs and outcomes. Int Wound J 2018;15:29-37. 10.1111/iwj.12814 29243398
4 Vivas A, Lev-Tov H, Kirsner RS. Venous leg ulcers. Ann Intern Med 2016;165:ITC17-32. 10.7326/AITC201608020 27479227
5 Comerota A, Lurie F. Pathogenesis of venous ulcer. Semin Vasc Surg 2015;28:6-14. 10.1053/j.semvascsurg.2015.07.003 26358304
6 Crawford JM, Lal BK, Durán WN, Pappas PJ. Pathophysiology of venous ulceration. J Vasc Surg Venous Lymphat Disord 2017;5:596-605. 10.1016/j.jvsv.2017.03.015 28624002
7 Shbaklo H, Holcroft CA, Kahn SR. Levels of inflammatory markers and the development of the post-thrombotic syndrome. Thromb Haemost 2009; 101:505.
8 Shiman MI, Pieper B, Templin TN, Birk TJ, Patel AR, Kirsner RS. Venous ulcers: A reappraisal analyzing the effects of neuropathy, muscle involvement, and range of motion upon gait and calf muscle function. Wound Repair Regen. 2009;17(2):147–152.
9 Vivas A, Lev-Tov H, Kirsner RS. Venous leg ulcers. Ann Intern Med 2016;165:ITC17-32. 10.7326/AITC201608020 27479227
10 Hedayati N, Carson JG, Chi YW, Link D. Management of mixed arterial venous lower extremity ulceration: A review. Vasc Med. 2015;20(5):479–486.
11 Dix FP, Reilly B, David MC, et al. Effect of leg elevation on healing, venous velocity and ambulatory venous pressure in venous ulceration. Phlebology. 2005;20(2):87-94.
12 Finlayson K, Edwards H, Courtney M. Relationships between preventive activities, psychosocial factors and recurrence of venous leg ulcers: a prospective study. J Adv Nurs. 2011;67(10):2180-2190.
13 Gross EA, Wood CR, Lazarus GS, Margolis DJ. Venous leg ulcers: An analysis of underlying venous disease. Br J Dermatol. 1993;129(3):270–274
14 Orr L, Klement KA, McCrossin L, O’Sullivan D, Houghton PE, Spaulding S, Burke S. A systematic review and meta-analysis of exercise intervention for the treatment of calf muscle pump impairment in individuals with chronic venous insufficiency. Ostomy Wound Manag. 2017;63(8):30–43.
15 Jull A, Slark J, Parsons J. Prescribed exercise with compression vs com- pression alone in treating patients with venous leg ulcers: a systematic review and meta-analysis. JAMA Dermatol. 2018;154(11):1304-1311.
16 Andreissen A, Apelqvist J, Mosti G, Partsch H, Gonska C, Abel M. Compression therapy for venous leg ulcers: Risk factors for adverse events and complications, contraindications: A review of present guidelines. J Eur Acad Dermatol Venereol. 2017;31(9):1562–68.
17 Dolibog P, Franek A, Taradaj J, et al. A comparative clinical study on five types of compression therapy in patients with venous leg ulcers. Int J Med Sci. 2013;11(1):34-43.
18 Vivas A, Lev-Tov H, Kirsner RS. Venous leg ulcers. Ann Intern Med. 2016; 165(3):ITC17-ITC32.
19 Dolibog P, Franek A, Taradaj J, et al. A comparative clinical study on five types of compression therapy in patients with venous leg ulcers. Int J Med Sci. 2013;11(1):34-43.
20 Nelson EA, Bell-Syer SE. Compression for preventing recurrence of venous ulcers. Cochrane Database Syst Rev. 2014;(9):CD002303.
21 O’Meara S, Al-Kurdi D, Ologun Y, et al. Antibiotics and antiseptics for venous leg ulcers. Cochrane Database Syst Rev. 2014;(1):CD003557.
22 Tate S, Price A, Harding K. Dressings for venous leg ulcers. BMJ. 2018; 361:k1604.
23 Chapman S. Venous leg ulcer: An evidence review. Br J Community Nurs. 2017;22(Suppl 9):S6–S9.
24 James GA, Swogger E, Wolcott R, Pulcini ED, Secor P, Sestrich J, et al. Biofilms in chronic wounds. Wound Repair Regen. 2008;16(1):37–44.
25 Phillips PL, Yang Q, Davis S, Sampson EM, Azeke JI, Hamad A, et al. Antimicrobial dressing efficacy against mature Pseudomonas aeruginosa biofilm on porcine skin explants. Int Wound J. 2015;4(12)483–469.
26 Jull AB, Arroll B, Parag V, et al. Pentoxifylline for treating venous leg ulcers. Cochrane Database Syst Rev. 2012;(12):CD001733.
27 Scallon C, Bell-Syer SEM, Aziz Z. Flavonoids for treating venous leg ulcers. Cochrane Database Syst Rev. 2013;(5):1–41.
28 Martinez-Zapata MJ, Vernooij RW, Uriona Tuma SM, et al. Phlebot- onics for venous insufficiency. Cochrane Database Syst Rev. 2016;(4): CD003229.
29 Del Rio Sola ML, Antonio J, Fajardo G, Vaquero Pureta C. Influence of aspirin therapy in the ulcer associated with chronic venous insufficiency. Ann Vasc Surg. 2012;26(5):620–629.
30 Evangelista MT, Casintahan MF, Villafuerte LL. Simvastatin as a novel therapeutic agent for venous ulcers: a randomized, double-blind, placebo-controlled trial. Br J Dermatol. 2014;170(5):1151-1157.
31 Gethin G, Cowman S, Kolbach DN. Debridement for venous leg ulcers. Cochrane Database Syst Rev. 2015;(9):1–63.
32 Cardinal M, Eisenbud DE, Armstrong DG, et al. Serial surgical debride- ment: a retrospective study on clinical outcomes in chronic lower extremity wounds. Wound Repair Regen. 2009;17(3):306-311.
33 Falanga V. Wound bed preparation and the role of enzymes: a case for multiple actions of the therapeutic agents. Wounds. 2002;14(2): 47-57.
34 Dumville JC, Worthy G, Bland JM, et al. Larval therapy for leg ulcers (VenUS II): randomised controlled trial. BMJ. 2009;338:b773.
Barwell JR, Davies CE, Deacon J, Harvey K, Minor J, Sassano A, et al. Comparison of surgery and compression with compression alone in chronic venous ulceration (ESCHAR study): Randomised controlled trial. Lancet. 2004;363(9424):1854–59.
International Wound Infection Institute (IWII). Wound Infection in Clinical Practice: Principles of Best Practice. Wounds International. 2016. Retrieved from: www.woundinfection
O’Meara S, Al-Kurdi D, Ologun Y, Ovington LG, Martyn-St James M, Richardson R.
Antibiotics and antiseptics for venous leg ulcers. Cochrane Database Syst Rev. 2014;(1):1–190.
Published
2020-02-09
How to Cite
1.
Gaus D. Venous Stasis Leg Ulcers: A Review. PFR [Internet]. 2020Feb.9 [cited 2025Apr.16];5(1). Available from: https://practicafamiliarrural.org/index.php/pfr/article/view/139
Section
Artículos de revisión
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